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Modelling suggests ABO histo-incompatibility may substantially reduce SARS-CoV-2 transmission

Ellis, Peter J.I. (2021) Modelling suggests ABO histo-incompatibility may substantially reduce SARS-CoV-2 transmission. Epidemics, 35 . Article Number 100446. ISSN 1755-4365. (doi:10.1016/j.epidem.2021.100446) (KAR id:87049)


Several independent datasets suggest blood type A is over-represented and type O under-represented among COVID-19 patients. However, blood group antigens appear not to be conventional susceptibility factors in that they do not affect disease severity, and the relative risk to non-O individuals is attenuated when population prevalence is high. Here, I model a scenario in which ABO transfusion incompatibility reduces the chance of a patient transmitting the virus to an incompatible recipient – thus in Western populations type A and AB individuals are “super-recipients” while type O individuals are “super-spreaders”. This results in an offset in the timing of the epidemic among individuals of different blood types, and an increased relative risk to type A/AB patients that is most pronounced during early stages of the epidemic. However, once the majority of any given population is infected, the relative risk to each blood type approaches unity. Published data on COVID-19 prevalence from regions in the early stages of the SARS-CoV-2 epidemic suggests that if this model holds true,

ABO incompatibility reduces virus transmissibility by at least 60 %. Exploring the implications of this model for vaccination strategies shows that paradoxically, targeted vaccination of either high-susceptibility type A/AB or “super-spreader” type O individuals is less effective than random vaccination at blocking community spread of the virus. Instead, the key is to maintain blood type diversity among the remaining susceptible individuals. Given the good agreement between this model and observational data on disease prevalence, the underlying biochemistry urgently requires experimental investigation.

Item Type: Article
DOI/Identification number: 10.1016/j.epidem.2021.100446
Uncontrolled keywords: SARS-CoV-2, Enveloped virus, Glycoprotein, ABO blood group, Modelling
Subjects: Q Science > QH Natural history > QH426 Genetics
Q Science > QR Microbiology > QR355 Virology
R Medicine > RA Public aspects of medicine > RA421 Public health. Hygiene. Preventive Medicine
Divisions: Divisions > Division of Natural Sciences > Biosciences
Depositing User: Peter Ellis
Date Deposited: 10 Mar 2021 20:43 UTC
Last Modified: 14 Nov 2022 23:11 UTC
Resource URI: (The current URI for this page, for reference purposes)

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